The monocyte-to-lymphocyte ratio and depression in diabetes patients

Abstract

Background: The purpose of this study was to determine the association between The monocyte-to-lymphocyte ratio (MLR) and depression with diabetes mellitus.Method: We examined data from the US National Health and Nutrition Examination Survey from 2009 to 2016. Cox proportional hazard models were used to calculate the associations between MLR and depression. For precise investigation of the relationship, we also plotted the smooth curve fit and generated a two-piecewise linear regression model using the penalized spline method.Result: We enrolled 2820 diabetes patients in the database. Diabetes patients who had high MLR tended to be young, female, obese, unmarried, and had low levels of education. For tertile analysis, the ORs and 95% CIs of clinically relevant depression in tertile analysis were 1.03 (0.91, 1.17) for the second group and 1.62 (1.44, 1.82) for the third group in the unadjusted model compared to the control group. A similar trend was observed for the adjusted model and the quartiles analysis. We found the inflection point of MLR was 2.7. There is a positive association between MLR and depression above the threshold, and no relationship was found when MLR was below the threshold in diabetes patients. Conclusion: There is a nonlinear relationship between MLR and depression in diabetes patients. High level of MLR more than the inflection point may add prognostic information for depression in diabetes patients.